South Los Angeles is sick – and it's going to be a long time before it gets better.

That's according to Nicole Vick, a health educator for the Area Health Office for Service Planning Areas (SPAs) 5 and 6 in the L.A. County Department of Public Health. SPA 6 is comprised of Los Angeles' southern region.

She says the southside has "some of the worst health outcomes in the county, especially when it comes to things like chronic diseases." She cited the disproportionate number of cases of obesity, diabetes, hypertension and sexually-transmitted diseases – chlamydia and gonorrhea, specifically.

Vick's statement is reflective of a reality that's also become clear through OnCentral's health coverage of South Los Angeles.

For example, even though research may bring to light more benefits of preventative care, the level of access to affordable, quality health care in South L.A. is still far and below what it ought to be.

The list goes on, and Vick says that although personal responsibility does play a role, there are also social determinants of health to factor in – things like education, home ownership, wealth, employment and "things that are not typically considered health issues, but are related to health."

Social determinants of health in South L.A.

"If a person has low education, that leads into issues of maybe lack of employability, which would mean that person would not have access to health care," said Vick. "So it all kind of feeds into each other, and the idea is that if we work on the social status of individuals, we ultimately will improve their health."

Focusing solely on eradicating one of the southside's chronic problems – diabetes, for example – wouldn't be doing much to solve the greater problem, she added.

"I always say if you just target one disease, you don't deal with the issue," Vick explained. "You're working downstream trying to prevent diabetes, but you're not looking upstream at the fact that there aren't enough grocery stores in these neighborhoods."

And those social determinants Vick was talking about? The L.A. Times' Mapping L.A. project gives it to us in a nutshell: Only 8.2 percent of residents 25 and older in South L.A. have a four-year degree; more than six times as many are high-school dropouts. More than 63 percent rent their homes rather than own it. The majority of households make $20,000 a year or less. And the latest data shows that Los Angeles' unemployment rate was at 13.3 percent, a statistic which tends to manifest in even higher percentages in South L.A.

These social determinants, said Vick, mitigate personal responsibility in many cases. She said one of the biggest misconceptions about the area is that residents are at fault, somehow, for their situations.

"When you understand institutional racism, when you understand why certain zoning laws exist, or why a Ralph's just closed down," she said. "Why is it that there's x amount of liquor stores in this area? When you understand those types of things, [you realize that a lot of it] is not really the fault of the residents of a neighborhood."

Personal responsibility does have "to be in the equation," though, said Vick, who added that South L.A.'s biggest health problems probably have to do with lifestyle. "Again, it's not the person's fault, it's just where they are," she said. "It's healthy food access, eating well and exercise."

STDs, she added, are also a problem in Supervisor Mark Ridley-Thomas' Second District, which is currently in a campaign that's reaching out to people and imploring them to get tested and treated.

"Again, it's all linked to the social determinants of health," she said. "If you don't have the same kind of access to education and work as some better-off people might, you're not really concerned with those things on some level."

As expected, the solution to such a deeply embedded problem won't be found or implemented overnight. But Vick believes South L.A. can get better, pointing to things like CicLAvia and the new clinic being built at Fremont High School as signs that the area is on a upswing, albeit a slow one. Health education and engaging residents – getting them to understand social determinants of health – is also key for her.

"I think it can be fixed – just like it was done, it can be undone," she said. "It's just going to take a long time. It didn't happen overnight, so we can't repair it overnight."

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